There is a range of information and support available for healthcare professionals and women with Nausea and Vomiting of Pregnancy.
Frequently asked questions
What is the difference between Nausea & Vomiting of Pregnancy and hyperemesis gravidarum?
What causes Nausea and Vomiting of Pregnancy?
NVP is the most common medical illness of pregnancy, affecting up to 80% of all pregnant women.1-3
The most severe form of NVP is called hyperemesis gravidarum (HG). The symptoms of HG are signifcantly worse than less severe forms of NVP and may not improve within the first few months of pregnancy.4 11% of women experience severe NVP,5 of which, up to 3.6% experience hyperemesis gravidarum (HG).2,3,6
The criteria for defining HG has not been clearly defined7 and HG as a diagnosis goes back to criteria set out by Fairweather in 1968 where HG diagnosis involved: dehydration, electrolyte imbalance and hospital admission.8 However since then, we know that women who have both moderate and severe NVP are admitted to hospital for various reasons.41,42
The severity of nausea and vomiting of pregnancy can be assessed using the Pregnancy Unique Quantification of Emesis score (PUQE score).43
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How safe is Xonvea for my patients and their unborn child?
The precise cause of NVP is unknown, although there is consensus that the disorder is multifactorial and a number of risk factors have been identified.9 These include:4,9,10
- Maternal genetics
- Previous history of nausea e.g. motion sickness or when taking the oral contraceptive pill
- Previous history of migraines
- Nutritional deficiencies
- Higher levels of oestrogen and/or hormone human chorionic gonadotropin (HCG)
How effective is Xonvea at treating Nausea and Vomiting of Pregnancy?
Xonvea is designed specifically for the treatment of NVP and studies indicate no fetal toxicity of Xonvea in pregnant women.11
- Over 33,000,000 pregnant women between 1956-19831,6
- 40 years of data in pregnant women6,12
- 2 meta-analyses involving data from more than 200,000 pregnancies13,14
These data show no significant increase in the risk of birth defects including cardiac defects, limb reduction defects, oral clefts, genital tract malformations and adverse neurodevelopment versus standard care.13-16
The combination of doxylamine succinate and pyridoxine hydrochloride was awarded the highest safety rating for a pregnancy drug at launch in the USA.17,18
A large amount of data on pregnant women indicates no malformative nor feto/neonatal toxicity.11
Xonvea – side effect profile11
There has been vast clinical experience regarding the use of the Xonvea combination (doxylamine/pyridoxine) use in pregnancy dating back to 1956.11,12
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- Nervous system disorders: somnolence (very common); dizziness (common).
- Gastrointestinal disorders: dry mouth (common).
- General disorders and administration site conditions: fatigue (common).
What are the other options to manage Nausea and Vomiting of Pregnancy?
Xonvea significantly improves the symptoms and quality of life for women with NVP versus placebo19 and there is a large body of research for the efficacy and safety of the doxylamine/pyridoxine combination use in pregnancy.13-15,20-39
In a questionnaire-based study engaging Irish healthcare professionals (83 obstetricians, 27 GPs, 18 midwives and 4 dieticians) who gave their expert opinion of doxylamine/pyridoxine combination use in their patients, frequency of use and its clinical efficacy.38 89% of HCPs responded (n=117):
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- 97.5% of all healthcare professionals responded that pyridoxine/doxylamine was a very effective medication for NVP38
- 90-100% of the healthcare professionals either willing to use the medicine personally or would advise a partner to use it to manage NVP38
- 63% of GPs prescribe the medication38
Why would I prescribe Xonvea over other management options?
The National Institute for Health and Care Excellence (NICE) clinical guidance recommends non-pharmacological interventions for pregnant women suffering from NVP as 1st line conservative treatment (e.g., diet, ginger, wrist acupressure) with anti-histamines as 1st line pharmacotherapy treatment.40
The RCOG Guidelines on the Management of NVP and HG suggests that if initial treatments such as dietary advice or rest have failed, and the woman has persistent symptoms, pharmacological intervention with an anti-emetic should be considered3 (although nearly all remain off licence).
Xonvea (doxylamine succinate 10mg/pyridoxine hydrochloride 10mg) is the only licensed anti-emetic for NVP in women who have not responded to conservative management.11 For more information on Xonvea, please visit the Xonvea page (which can be located in the menu at the top of the page) or click here.
Xonvea is intended for use in pregnancy and is the only licensed medicine in the UK for the treatment of nausea and vomiting in pregnancy in women where conservative management has failed.11
Xonvea contains one of the most studied drug combination in pregnancy, designed specifically for NVP, with over 33,000,000 prescriptions between 1956-1983, 40 years of data in pregnant women and 2 meta-analyses involving data from more than 200,000 pregnancies.6,12-14 Studies indicate no fetal toxicity by taking Xonvea.11
There has been vast clinical experience regarding the use of the Xonvea combination (doxylamine/pyridoxine combination) use in pregnancy dating back to 1956.6,11
Currently, approximately a third of women who attend GP practice are prescribed an off licence medication for NVP39
Further information about Xonvea can be found within the sections of this website: